102 Background: The Canadian Partnership Against Cancer recently released a system performance report identifying large variation in breast cancer treatment across Canada. Contrary to provincial guidelines, Alberta had higher than average rates of mastectomy (56%); however, factors driving this variation remain unknown. We sought to (1) determine if practice patterns of primary breast surgery and adjuvant therapy adhered to guidelines and (2) to describe influencing factors on treatment practices between the two major cancer programs in Alberta to inform future knowledge translation strategies for guideline implementation. Methods: All patients diagnosed with breast cancer (ICD 9-174) between January 2009 and December 2010 were identified from the Alberta Cancer Registry. Demographic, surgical, treatment, and pathology data were abstracted from the electronic health record. Descriptive statistics and t-testing comparing mastectomy rates, axillary surgery and adjuvant therapy between the two major cancer programs were performed. Results: There were 2,817 surgeries for early breast cancer in the study cohort between 2009 and 2010. Conclusions: Practice patterns identify variance from current guidelines. Mastectomy rates are influenced by surgeon volume and tumor size. Management of positive SN and adjuvant therapy is variable and may reflect under treatment. Further investigation of drivers for mastectomy and adjuvant therapy are necessary. [Table: see text]
Omitting Axilla Lymphadenectomy Even by Positive Sentinel Lymph Node: A Change in Breast Cancer Treatment Practice